Tooth Movement & Loss

A filling or crown has fallen out: what should I do?

The piece that fell out is not the problem itself but the result; what really matters is what lies underneath

You felt something hard in your mouth during a meal, and when you ran your tongue over the tooth you found a hole in the middle of it. On this page we explain why a filling or crown falls out, what to do with the piece that came out, how many days you can wait and where the tooth is heading if you put it off.

Short answer

Keep a crown that has fallen out, throw away a piece of filling that has fallen out, and show the tooth to a dentist without delay. A crown can be cleaned and cemented back on; a broken piece of filling is not reused. A restoration usually falls out because of decay spreading underneath, a fracture or cement that has dissolved, so the real job is not closing the hole but treating the cause. The exposed walls of the tooth have no support and break under the load of chewing. If you have swelling, a fever or throbbing pain, see a dentist the same day.

If a crown has fallen out: Keep it and bring it in a dry container
If a piece of filling has fallen out: It is not stuck back in; throw it away
How long you can wait: Measured in days, not weeks
See a dentist the same day: Swelling, fever, throbbing pain

Medically reviewed by Bilge Ilgın, Dentist · ImplantologyLast reviewed 2026-08-31

Why a filling or crown falls out

Neither a filling nor a crown fuses with the tooth. A composite filling holds on to the enamel and dentine surface with a bonding agent; a crown sits on the reduced tooth with cement. In both there is an interface between the tooth and the material, and that interface works under the harshest conditions in the mouth: chewing forces repeated thousands of times a day, the difference in expansion between hot and cold, constant moisture and acid. The moment it gives way is the moment that interface first tells you it broke down long ago.

The most common cause is decay spreading underneath. A gap that cannot be seen with the naked eye opens at the edge of the filling, bacteria get in and dissolve the dentine under the material. While the tooth looks intact from the outside, the base holding the restoration softens on the inside; after a certain point the filling is sitting over a hollow and comes out with an ordinary mouthful. If the underside of the piece that fell out is black, soft and smelly, what you are looking at is not an accident but the last step of decay that has been going on for months.

The second cause is a fracture. A large filling leaves only thin walls of the tooth's own tissue. Over the years, amalgam fillings expand and contract with heat and force these walls apart like a wedge; with a hard mouthful, one of the cusps cracks and breaks off together with the filling. In that case, the piece that fell out also contains tooth tissue. How far down the fracture goes decides the rest of the tooth's story.

The third cause is loss of fit, and it is seen more often with crowns. When the line between the edge of the crown and the tooth breaks down on a microscopic scale, the cement comes into contact with saliva, dissolves over time and washes out. The crown stays in place more or less out of habit for a while, then comes off whole with a sticky mouthful. In root-treated teeth the same thing happens to the post that holds the crown: the post works loose, and the crown comes out with it.

The fourth is excessive load. In people who clench their teeth at night, the chewing muscles contract in repeated bursts throughout sleep, without you being aware of it, many times over the night and with forces you never reach when chewing during the day. No restoration is designed for this repetition. The same goes for a filling that has been left too high in the bite: every time you close your jaw, that surface takes the first contact. The signs are a tired jaw in the morning, flattened tooth surfaces and restorations falling out one after another.

The piece that fell out is itself a diagnostic clue. A crown that is clean and intact inside says the cause was the cement; a filling with crumbling edges and a soft underside points to decay; a piece carrying tooth tissue means a fracture. By looking at this piece, your dentist starts out knowing what to look for in the tooth.

Which can wait a few days and which cannot

Not every restoration that falls out is equally urgent. What makes the distinction is not the size of the hole but what the tooth is telling you.

The tooth can be saved

A small filling has fallen out and there is no painIf the hole is small, the edges are not sharp and hot and cold do not bother you, this tooth can wait for an appointment within a few days. Stop chewing on that side; the concern while it waits is not pain but the exposed dentine.
The crown came out whole and the tooth underneath does not hurtIf the crown came out in one piece and the stump underneath is sound, the same crown is cleaned and cemented back on. Keep the crown in a dry container and see a dentist this week.
Sensitivity to cold that stops once the trigger has goneExposed dentine passes heat and cold straight to the nerve. If the pain goes within a few seconds of putting the drink down, this is mostly a reversible sensitivity; what confirms it is an examination and an X-ray, so still book an appointment for this week.

Saving it is unlikely to hold

Swelling in the gum, a fever or a swollen faceThese are signs of an abscess, and the infection has spread beyond the tooth. See a dentist the same day; with swelling that makes it hard to swallow or breathe, go straight to A&E.
Pain that gets worse with heat and does not ease at nightThrobbing that starts on its own and gets worse when you lie down shows that the tissue inside has become irreversibly inflamed. In this situation, what needs discussing is not a filling but root canal treatment, and waiting makes the pain worse.
The crown has come off a root-treated toothWhen the seal over the root filling is lost, saliva and bacteria leak into the canal. This leakage is silent, and within weeks it reinfects a treatment finished years ago. Do not leave this tooth exposed for days.
A sharp edge is cutting your tongue or cheekThe edge left by a broken-off cusp is like a razor blade and opens a sore in the soft tissue that is reopened every day. This edge needs smoothing within the same week.
The tooth moves when you bite, or the remaining wall has come awayIf part of the tooth moves after the piece has broken off, the fracture has gone below the gum line. Here, every day of delay directly affects whether the tooth can be saved.

What to do from the moment it falls out

What you do in the first few hours is simple, but the order matters. The aim is not to fill the hole but to get the tooth to the dentist without it getting worse.

1
Sort the piece: keep a crown, throw away a filling
If a crown, bridge or inlay came out in one piece, rinse it under running water and put it in a dry container with a lid; do not wrap it in a tissue, because that tissue ends up in the bin. A broken piece of composite or amalgam is not stuck back in, so there is no point keeping it. If you have swallowed the piece, it will pass through your digestive system; if coughing, wheezing or shortness of breath starts, go to A&E at once.
2
Clean your mouth and leave the hole alone
Rinse with warm salt water; this washes away any food left in the hole. Do not stop brushing; keep cleaning that area gently with a soft brush. Do not plug the hole with cotton wool, wax or chewing gum; these trap bacteria inside.
3
Stop chewing on that side
The walls of a tooth that has lost its restoration are left without support and break with an ordinary mouthful. Once the fracture goes below the gum line, the future of that tooth changes. Chew anything hard, sticky, very hot or very cold on the other side.
4
Do not stick the crown back on with household glue
Superglue is not made for use in the mouth; it irritates the tissue, hardens inside the crown so that it cannot be used, and makes proper cementing impossible. Temporary cement from the chemist is a stopgap for a few days: use it if the crown is in one piece, clean and seats fully without forcing; if it does not seat, do not press it on.
5
At the dentist, the real state of the tooth comes to light
The dentist first cleans the hole and removes all the decay underneath; only then can its true size be seen. Then three things are checked: how many sound walls are left, how close the decay has come to the tissue inside, and whether the fracture has gone below the gum line. In root-treated teeth, the X-ray also shows inflammation at the tip of the root.
6
The repair is decided
If enough tooth tissue is left, the tooth is closed with a new filling. If most of the walls have gone, a filling has nothing to hold on to, and an onlay or crown that wraps around the tooth is needed. If the tissue inside is irreversibly inflamed, root canal treatment comes first and a crown goes on top. What decides this is not the size of the piece that fell out but how much is left.

Repair options

These are not rivals; they are steps ordered by how much tooth tissue is left. The sooner you come in, the higher up the list you stay.

A new filling

If sound walls are left once the decay has been cleaned out, the tooth is closed with composite and it is done in a single session. This is the cheapest step on the list and the one that loses the least tissue. A patient who has the lost filling replaced straight away stays here.

Cementing the same crown back on

If the crown is intact, the stump underneath is sound and the fit at the edges has not deteriorated, the same crown is cleaned and cemented again. It takes a single session, and no new impression is taken. The precondition is that you have brought the crown with you.

An onlay or crown

When there are no walls left for a filling to hold on to, a restoration that wraps around the tooth from the outside is needed; the remaining tissue is supported all the way round like a band, and chewing force is spread over the whole tooth rather than into the cracks. This is where people most often end up after a large filling falls out.

Root canal treatment with a crown on top

If the decay has reached the tissue inside, or the crown has come off a root-treated tooth and the canal has been left open to the mouth, the inside is cleaned first and then the tooth is covered with a crown. A root-treated tooth becomes brittle; leaving it without a crown is the quickest way to lose that tooth a second time.

Extraction and an implant

If the fracture has gone well below the gum line or there is no tissue left to hold on to, the repair steps come to an end. At that point the question is not forcing the tooth but what we will fill the gap with. We place an implant in its place and do not touch the neighbouring teeth.

What happens when it is put off

We write these down not to frighten you, but so that you can see what each day of waiting costs. We regularly see every link in this chain at the clinic.

An exposed tooth breaks

A restoration does not just fill the space inside the tooth; it binds the remaining walls together. When that bond is gone, the walls carry the load on their own and crack with an ordinary mouthful. When the fracture goes below the gum line, repair becomes harder: some teeth can still be saved with additional procedures such as crown lengthening, while those where it goes very deep end in extraction. In other words, every day of waiting shifts which side the tooth ends up on.

Decay goes deeper than it looks from outside

Decay under a filling never stops progressing, and once the hole has opened, it gives bacteria a direct way in. When it reaches the tissue inside, it is no longer a question of a filling. A tooth that could have been closed with a filling a week ago needs root canal treatment a few months later.

Leakage into a root-treated tooth progresses silently

When the crown falls out, the seal over the root filling is lost and saliva makes its way into the canal. Because this tooth does not hurt, the patient does not hurry; by the time the infection reaches the tip of the root, a treatment finished years ago has to be redone from scratch or the tooth is extracted.

The neighbouring tooth tips into the gap

Losing the restoration also takes away the contact point with the neighbouring tooth. The neighbouring tooth tips slightly into this space, and this movement starts within weeks; after a while, the crown you kept no longer seats in the same way. That is why a crown that could have been cemented back on ends up having to be made again from scratch.

Sensitivity turns into pain, and pain into an abscess

Exposed dentine first twinges with cold, then starts to throb with heat, and finally hurts on its own. This sequence does not go into reverse. Stories that end with a swollen face begin with a filling that fell out months earlier and was ignored.

Temporary fixes last only days

Temporary cement from the chemist and temporary filling paste do not protect the tooth from infection, do not stop it breaking and do not stop the decay spreading underneath; they only reduce sensitivity. Use a temporary fix until your appointment, not instead of it.

What to expect after the repair

The sequence below covers the whole route, from a repair that ends with a new filling to a tooth that cannot be saved. Which point you end up at is decided by how much sound tissue is left in the tooth when you come to the dentist.

The first few days
Sensitivity to cold lasting a few days after a new filling or crown is normal; if deep decay was cleaned out, it lasts a little longer and gradually eases. If you feel one surface touching before the others when you bite, call your dentist: a surface left too high is corrected in a few minutes.
Two to four weeks
The sensitivity goes and you go back to using the tooth normally. If a permanent crown was fitted, the gum margin settles during this time. After this point, pain that gets worse or starts again needs following up.
If root canal treatment was done
For a few days after the procedure, tenderness when biting continues and fades gradually. Until the root-treated tooth has been covered with a permanent restoration, do not chew anything hard on that side; this gap is when a tooth that has become brittle is at its weakest.
If the tooth could not be saved
When there is no tissue left to hold on to, we extract the tooth and place an implant in its place. If a single tooth is involved, the gap is closed with a single implant, and you can carry this out with your own dentist. Our field is many missing teeth and the full mouth; there, the process works like this: in the protocol we use, the implants lock mechanically into the hard basal and cortical layer deep in the jaw. A conventional implant, by contrast, is placed in the upper part that shrinks along with the denture after tooth loss, the alveolar bone; the bone it holds on to keeps shrinking, and fusion has to be waited for over months. That is where the difference comes from. Adding bone and months of waiting do not come into it, and at the end of three clinical days you leave with your final fixed teeth. After that, care is no different from natural teeth: brushing, cleaning between the teeth and regular check-ups. If you have a history of clenching at night, we bring in a night guard.

Message us right away if

Pain getting worse after a new filling or crown. If sensitivity that should be easing grows day by day, there is an unresolved problem underneath. Call without waiting for your appointment.
Swelling or discharge in the gum, or a fever. These are signs of active infection and need to be assessed the same day.
A restoration that has fallen out again soon after. Repeated loss in the same place shows that the remaining tooth tissue is not enough or that a force from the bite has not been dealt with. We talk the plan through again rather than repeating the same procedure a third time.

What determines the cost

We do not give a single figure on this page: with a restoration that has fallen out, the route may end with a single-session filling, or it may extend to root canal treatment, a crown, or extraction and an implant; the difference between them is large. We give you the right figure once we have seen inside the tooth. Send us your X-ray and we will share the scope with you in writing. These are the items that determine the price:

The tooth tissue that is left: A filling, an onlay and a crown are different procedures, with different lengths, materials and numbers of sessions. What decides this item is not the size of the piece that fell out but the walls left standing once the decay has been cleaned out.
Whether the tissue inside needs treating: If decay has reached the tissue inside, root canal treatment and then a crown come into it; the more canals there are, the longer the procedure. For a patient who comes in early, this item never arises.
How many teeth are affected: Replacing a single filling and replanning from scratch a mouth that keeps losing restorations one after another are costed separately. In the second case, the bite and gum health also need to be addressed.
The material and laboratory work: The material of the crown and the laboratory stage have a direct effect on the total. We tell you in writing from the start which brand of material we use.

Frequently asked questions

Should I keep my filling that fell out?

No. A broken piece of composite or amalgam filling is not stuck back in; your dentist has no need for it. Crowns, bridges and inlays are the opposite: keep them in a dry container with a lid and bring them with you, because the same piece can be cleaned and cemented back on.

Can I stick my crown back on at home?

Do not use superglue or any household glue. These materials are not made for use in the mouth; they irritate the tissue and harden inside the crown so that it cannot be used, and the dentist can then no longer seat that crown. Temporary cement from the chemist does the job for a few days until your appointment, and no more.

I have no pain. How many days can I wait?

The waiting time is measured in days, not weeks. No pain does not mean the decay underneath has stopped, and the exposed walls are at risk with every mouthful. Do not let it go beyond a week; if the crown has come off a root-treated tooth, do not wait even that long.

The same tooth has lost its filling for the third time. Why?

Repeated loss in the same place tells you one of two things: either the remaining tooth tissue is not enough for the filling to hold on to, or the force reaching that tooth from the bite is too great. In the first case the solution is an onlay or crown that wraps around the tooth; in the second it is correcting the bite and, if you clench at night, wearing a night guard. Doing the same filling a fourth time is a waste of time.

My crown fell out and the tooth underneath is jet black. Is it decayed?

A dark colour alone does not mean decay; root-treated teeth and the stumps under crowns with a metal framework discolour anyway. Decay is identified not by colour but by how hard the tissue is. The dentist cleans the surface and sees whether there is any softened area.

If my tooth cannot be saved, can an implant be placed straight away?

If a conventional implant is to replace a single tooth: if the bone walls of the socket are sound and the inflammation is under control, the implant can be placed in the same session; in an area where the bone has shrunk, healing is waited for first. We make this decision by looking at a CBCT scan. With the full-mouth protocol the question does not even arise: because the implants lock not into the walls of the socket but into the hard layer deep in the jaw, there is no need to wait.

Just one of my fillings has fallen out. Is your fixed teeth in three days method right for me?

Most likely not, to be frank. The protocol we use is for the full mouth or many missing teeth. For a single filling that has fallen out, what needs doing is replacing the filling, and for that, carrying on with your own dentist is enough. If we look at your X-ray and think it is not suitable for you, we tell you that in writing too.

Sources

Send your X-ray and we will tell you which option is realistic for your tooth.

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Next step

Send your X-ray and we will talk through the options.

Share your CBCT or panoramic X-ray. We will write back within 24 hours on which option is realistic for your tooth.

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